Abstract
Hip fractures in the elderly are frequently associated with complications and unfavorable outcomes. Managing postoperative delirium, pain, sleep disturbances, and overall quality of life presents significant challenges in clinical care. This study aimed to explore the effectiveness of refined nursing interventions in improving postoperative recovery and patient satisfaction among elderly patients undergoing hip fracture surgery. A retrospective analysis was conducted on 252 elderly patients with surgically treated hip fractures admitted to Zhejiang Provincial People's Hospital and Tongxiang First People's Hospital between January 2021 and June 2024. To minimize selection bias, participants were allocated into 2 groups using propensity score matching, ensuring comparable baseline characteristics between the groups. The observation group (n = 126) received refined nursing care tailored to individual needs, while the control group (n = 126) received standard nursing care. Key outcomes assessed included the incidence and duration of postoperative delirium, hospital length of stay, pain intensity (visual analog scale), sleep quality (Pittsburgh Sleep Quality Index), quality of life (SF-36), recovery quality (the quality of recovery-40), and satisfaction with nursing care. Compared to the control group, patients in the observation group showed a marked reduction in both the incidence and duration of postoperative delirium. They also experienced shorter hospital stays and reported lower pain scores by the third postoperative day. Sleep quality was notably better on the first and third days following surgery. Moreover, assessments at 1 and 2 months postoperatively revealed significantly higher scores in both quality of life and recovery. Nursing satisfaction was also significantly enhanced in the refined care group (P < .05 for all comparisons). Refined nursing interventions, with a focus on personalized, comprehensive care strategies, significantly improve postoperative outcomes in elderly patients with hip fractures. These measures not only mitigate delirium and pain but also promote better sleep, faster recovery, improved life quality, and greater patient satisfaction, demonstrating meaningful clinical application.